Claim total
$774.06
base $93.83 · payer covered $774.06
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-08-05
- Stop
- 2023-08-05
The parties
- Patient
- patient Bernard Davis Von
- Provider
- provider Danilo Haley
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Dual Eligible
Record id
25aec34e-9c20-9510-d84d-dc0aea69c50c